The NHS has five levels of alert—“black alert” means there are systematic problems and people could be harmed by coming in. Across England, the number of trusts that are regularly on black alert is increasing.

We’re now on a road where we have to work harder, work more hours with less rest—and subject to useless processes designed to “ration” care.

In Bolton, where I work, to get a hip replacement people have to prove that they can’t get upstairs to bed to get onto the waiting list.

We’re drowning locally under budget cuts and privatisation. The Tories’ Sustainability and Transformation Plans (STPs) will only make that worse.

They’re done in secret and dressed up in smoke and mirrors about “integrating” health and social care.

They don’t shout about the fact that we’re going to lose beds, A&E departments or whole hospitals.

The opposition is coming from health campaigns and some health workers. Unfortunately, our Unison union isn’t opposed to STPs in principle because the leadership wrongly see it as bringing “integration”.

Drowning

Unison members were the biggest group represented on the 250,000-strong health demonstration on 4 March. But that came from branches—the union backed it late and it didn’t feel like we had national backing.

While health workers are increasingly angry, they’re not convinced that the union is place that will provide solution to that anger.

The leadership’s strategy has been holding people’s hands to survive until the next general election when we might get a Labour government.

The Royal College of Nursing met last week and are consulting their members on fighting on pay.

Unison’s consultation says there’s no mood to fight on pay so they want a dispute over regrading in each of the 12 regions. That’s a good local strategy and there could be local disputes that inspire others to fight.

But the message that there’s no general mood knocks down confidence.

We have to take a position and tell people—if you want end to how it is, we have to fight and this is how we could win.